Flonase vs Nasacort vs Rhinocort during pregnancy

How do the options compare?

Options are compared on ACOG or MotherToBaby endorsement, size and quality of pregnancy-specific studies, dosing predictability, time-to-effect, and side-effect profile: the same axes an obstetric clinician would use.

• Budesonide is the only intranasal corticosteroid with established safety in pregnancy, according to a clinical review of how these sprays are used. 1
• Fluticasone as a nasal spray is not expected to increase the chance of birth defects, and nasal or inhaled use puts lower amounts into the body than the same medication swallowed. 2
• Studies of inhaled corticosteroids, the class that includes budesonide, fluticasone propionate, and triamcinolone acetonide, have found no overall increased chance of birth defects. 3
• One spray of intranasal budesonide delivers 32 mcg, and the usual adult schedule is two sprays into each nostril once daily while sniffing gently. 4
• Steroid sprays are slow by design: daily use for 8 to 12 weeks is often required for full benefit, and the applicator should be aimed away from the nasal septum to limit local side effects. 1

Which option makes sense?

A comparison can include options that should be avoided or considered only in specific circumstances. Please consult your healthcare provider about the findings and cautions that apply to you.

Disclosure: Pregnancy Smart offers a supplement that overlaps with one or more options above. This page describes the pregnancy evidence for each option on its own merits.